Garpenhag Lars, Dahlman Disa
Center for Primary Health Care Research, Department of Clinical Sciences, Clinical Research Center/CRC, Lund University/Region Skåne, Box 503 22, Malmö, Sweden.
Division of Psychiatry, Department of Clinical Sciences Lund, Lund University, BMC I12, 221 84 Lund, Sweden.
Prev Med Rep. 2024 Feb 5;39:102641. doi: 10.1016/j.pmedr.2024.102641. eCollection 2024 Mar.
Women with current or previous drug use (WCPDU) have an increased risk of poor cervical and breast cancer outcomes, and low participation in screening for these cancer forms. The aim of this study was to assess self-reported barriers to and facilitators of cervical and breast cancer screening, among WCPDU.
A survey based on results from a previous qualitative study about WCPDUs experiences of cancer screening was distributed to WCPDU at six opioid agonist treatment (OAT) clinics and one needle exchange program (NEP) in Malmö, Sweden, and through the Drug Users Union in Stockholm, Sweden. Data on barriers to and facilitators of cancer screening reported by 222 non-adherent WCPDU was analyzed by descriptive statistics. The barriers were structured according to an established model of healthcare access.
The most frequently reported barriers to cervical as well as breast cancer screening were non-receipt of screening invitations (36 % and 25 %, respectively), trouble remembering the appointment (27 % and 30 %) and other priorities (26 % and 29 %). Common suggested facilitators for both cervical and breast cancer screening were screening access at, e.g., a NEP or OAT clinic (45 % and 40 %) and practical support to attend the screening appointment (40 % and 38 %).
In contrast to general population women, WCPDU report mainly practical barriers to cervical and breast cancer screening. However, NEP participants frequently reported experience of stigma and poor reception as barriers to screening. Interventions to minimize barriers to screening are crucial to decrease the increased cancer morbidity and mortality among WCPDU.
目前或既往有药物使用史的女性（WCPDU）患宫颈癌和乳腺癌的不良结局风险增加，且对这些癌症类型的筛查参与率较低。本研究的目的是评估WCPDU中自我报告的宫颈癌和乳腺癌筛查的障碍及促进因素。
基于一项先前关于WCPDU癌症筛查经历的定性研究结果的调查问卷，分发给瑞典马尔默的6家阿片类激动剂治疗（OAT）诊所和1个针头交换项目（NEP）的WCPDU，以及瑞典斯德哥尔摩的吸毒者联盟。对222名未坚持筛查的WCPDU报告的癌症筛查障碍及促进因素的数据进行描述性统计分析。这些障碍根据已确立的医疗保健可及性模型进行分类。
宫颈癌和乳腺癌筛查最常报告的障碍分别是未收到筛查邀请（分别为36%和25%）、难以记住预约时间（27%和30%）以及其他优先事项（26%和29%）。宫颈癌和乳腺癌筛查共同提出的促进因素包括在NEP或OAT诊所等机构进行筛查（45%和40%）以及参加筛查预约的实际支持（40%和38%）。
与普通女性人群相比，WCPDU报告的宫颈癌和乳腺癌筛查主要是实际障碍。然而，NEP参与者经常报告耻辱感和接待不佳是筛查的障碍。减少筛查障碍的干预措施对于降低WCPDU中增加的癌症发病率和死亡率至关重要。
